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“Before this breast band, my mother used the grinding stone heated in the fire to massage my chest. Every night my mother examines my chest (and) massages me, sometimes with the pestle. Although I cry hard because of the pain, mother tells me; Endure m daughter, you are young and there is no point in having breasts at your age.”

– Josaine Matia, 11 years old (Yaounde, Cameroon).

Breast ironing is a traditional practice where the mother massages the breasts of the girls in order to postpone their development to discourage unwanted male attention, rape or pre-material pregnancy. The tools used are usually a stone, hammer or a spatula that has been heated over coals. Other instruments are also wooden pestle used for pounding tubers in the kitchen and heated bananas and coconut shells. But the ironic part is that young Cameroonian girls are still getting pregnant at an early age such as 15 and the child usually dies at birth.

Youths make up 5,5% of the population with HIV and teenage pregnancy is increasing. Among the 200 different ethnic groups with different customs and traditions, the all have breast ironing in common. In an attempt to make their daughters less attractive to boys, mothers are ironing their breasts with hot objects to prevent them from developing but it’s unfortunately with the dietary habits improving in the country the last 50 years, girls has started to reach puberty as young as 9 years old.

Consequences

Breast ironing can lead to numerous physical issues such as depression, but also burns and deformations, and there are the risk of breast cancer and cysts. It is not only extremely painful but it also causes tissue damage, which can create difficulties with breastfeeding.

If a medical doctor can determine that damage has been caused to the breasts within a few months, the perpetrators can risk up to 3 years in prison. The mothers however defend themselves that they do it out of love.

Despite the problems caused by practice of “ironing breasts”, it has not yet been banned by authorities. “The Ministry for the Promotion of Women and the Family encourages in efforts to make parents aware of the dangers of the practice. Their aim is to encourage the authorities to come up with a law in the parliament to outlaw the practice. The more educated and exposed a woman is, the less likely she is to be convinced that it is the solution and they will most likely not perform it on their daughters.

Some numbers;

*Breast ironing appears to be most widely-practiced in Cameroon. It’s more common in the Christian and animist south of the country than the Muslim north, where only 10% of women are affected.

*It also occurs in Guinea-Bissau, West and Central Africa, including Chad, Togo, Benin, Guinea-Conakry.

It is estimated that at least 55% of British Pakistanis are married to first cousins and the tradition is also common among some other South Asian communities and in some Middle Eastern countries. But there is a problem: marrying someone who is themselves a close family member carries a risk for children, a risk that lies within the code of life, inside our genes. Communities that practice cousin marriage experience higher levels of some very rare but very serious illnesses known as recessive genetic disorders.

Such unions are seen as strong because they build on tight family networks and family events gets better because the in-laws are already related to each other and have the same family history. But the statistics for recessive genetic illness in cousin marriages is serious as British Pakistanis are 13 times more likely to have children with genetic disorders than the general population.

Cousin marriages

Cousin marriage is marriage between two cousins. This kind of marriage is highly stigmatized today in the West, but it does account for over 10% of marriages worldwide as it is common in the Middle East, where in some nations they account for over half of all marriages.

According to Professor Robin Fox of Rutgers University, it is likely that 80% of all marriages in history have been between second cousins or closer. It is generally accepted that the founding population of Homo sapiens was small, anywhere from 700 to 10,000 individuals. Rates of first-cousin marriage in the United States, Europe, and other Western countries like Brazil have declined since the 19th century, though even during that period they were not more than 3.63% of all unions in Europe. But in many other world regions cousin marriage is still strongly favoured: in the Middle East some countries have seen the rate rise over previous generations, and one study finds quite stable rates among Indian Muslims over the past four decades.

Cousin marriage has often been chosen to keep cultural values and ensure the compatibility of spouses, preserve familial wealth, sometimes via advantages relating to dowry or bride price. Other reasons may include geographic proximity, tradition, strengthening of family ties, maintenance of family structure, a closer relationship between the wife and her in-laws, greater marital stability and durability, ease of prenuptial negotiations, enhanced female autonomy, the desire to avoid hidden health problems and other undesirable traits in a lesser-known spouse, and romantic love.

United States

The United States has the only bans on cousin marriage in the Western world. As of February 2010[update], 30 U.S. states prohibit most or all marriage between first cousins together with other 6 states.

Cousin marriage was legal in all US states in the Union prior to the Civil War. However, according to Kansas sociology professor Martin Ottenheimer, after the Civil War the main purpose of marriage prohibitions was increasingly seen as less maintaining the social order and upholding religious morality and more as safeguarding the creation of fit offspring. By the 1870s, Lewis Henry Morgan was writing about “the advantages of marriages between unrelated persons” and the necessity of avoiding “the evils of consanguine marriage.” Cousin marriage to Morgan, and more specifically parallel-cousin marriage, was a remnant of a more primitive stage of human social organization. Morgan himself had married his mother’s brother’s daughter in 1851.

In 1846 the Governor of Massachusetts appointed a commission to study “idiots” in the state which implicated cousin marriage as being responsible for idiocy. Within the next two decades numerous reports appeared coming to similar conclusions, including for example by the Kentucky Deaf and Dumb Asylum, which concluded that cousin marriage resulted in deafness, blindness, and idiocy. Perhaps most important was the report of physician S.M. Bemiss for the American Medical Association, which concluded “that multiplication of the same blood by in-and-in marrying does incontestably lead in the aggregate to the physical and mental depravation of the offspring.”

These developments led to thirteen states and territories passing cousin marriage prohibitions by the 1880s. Though contemporaneous, the eugenics movement did not play much direct role in the bans, and indeed George Louis Arner in 1908 considered them a clumsy and ineffective method of eugenics, which he thought would eventually be replaced by more refined techniques. Ottenheimer considers both the bans and eugenics to be “one of several reactions to the fear that American society might degenerate.” In any case, by the period up until the mid-1920s the number of bans had more than doubled. Since that time, the only three states to successfully add this prohibition are Kentucky in 1943, Maine in 1985, and Texas in 2005. The NCCUSL unanimously recommended in 1970 that all such laws should be repealed, but no state has dropped its prohibition since the mid-1920s.

Europe

Only Austria, Hungary, and Spain banned cousin marriage throughout the 19th century, with dispensations being available from the government in the last two countries. Protestant, the Church of Sweden didn’t ban first-cousin marriage until 1680 and required dispensation until 1844. England maintained a small but stable proportion of cousin marriages for centuries, with proportions in 1875 estimated by George Darwin at 3.5% for the middle classes and 4.5 % for the nobility, though this has declined to under 1 % in the 20th century. Queen Victoria and Prince Albert were a preeminent example.

The 19th century academic debate on cousin marriage evolved differently in Europe than it did in America. The first-cousin marriage was legal in ancient Rome from at least the Second Punic War (218–201 BC) to its ban by the Christian emperor Theodosius I in 381 AD in the west and until after Justinian (d. 565 AD) in the east.

Early Catholic marriage rules forced a sharp change from earlier norms in order to deny heirs to the wealthy and therefore increase the chance they would will their property to the Church.

Middle East

The Middle East has uniquely high rates of cousin marriage among the world’s regions. Saudi Arabia, have rates of marriage to first or second cousins that may exceed 50%, Iraq was estimated in one study to have a rate of 33%, and figures for Iran and Afghanistan have been estimated in the range of 30–40%. Though on the lower end, Egypt and Turkey nevertheless have rates above 20%.

All states in the Persian Gulf currently require advance genetic screening for all prospective married couples. Qatar was the last Gulf nation to institute mandatory screening in 2009, mainly to warn related couples who are planning marriage about any genetic risks they may face. The current rate of cousin marriage there is 54%, an increase of 12–18% over the previous generation. A report by the Dubai-based Centre for Arab Genomic Studies (CAGS) in September 2009 found that Arabs have one of the world’s highest rates of genetic disorders, nearly two-thirds of which are linked to consanguinity. Research from CAGS and others suggests consanguinity is declining in Lebanon and Egypt and among Palestinians, but is increasing in Morocco, Mauritania and Sudan.

Dr. Ahmad Teebi, a genetics and pediatrics professor at Weill Cornell Medical College in Qatar, links the increase in cousin marriage in Qatar and other Gulf states to tribal tradition and the region’s expanding economies. “Rich families tend to marry rich families, and from their own – and the rich like to protect their wealth,” he said. “So it’s partly economic, and it’s also partly cultural.” In regard to the higher rates of genetic disease in these societies, he says: “It’s certainly a problem,” but also that “The issue here is not the cousin marriage, the issue here is to avoid the disease.”

Africa

Cousin marriage rates from most African nations outside the Middle East are unknown. It is however estimated that 35–50% of all sub-Saharan African populations either prefers or accept cousin marriages. In Nigeria, the most populous country of Africa, the three largest tribes in order of size are the Hausa, Yoruba, and Igbo. Muslim Hausa practice cousin marriage preferentially, and polygamy is allowed if the husband can support multiple wives. Divorce can be accomplished easily by either the male or the female, but females must then remarry. Even for a man, lacking a spouse is looked down upon. Baba of Karo’s first of four marriages was to her second cousin. She recounts in the book that her good friend married the friend’s first cross cousin.

The Yoruba people are split between Islam and Christianity. A 1974 study analyzed Yoruba marriages in the town Oka Akoko, finding that among a sample of marriages having an average of about three wives. These included not only cousin marriages but also uncle-niece unions. Reportedly it is a custom that in such marriages at least one spouse must be a relative, and generally such spouses were the preferred or favourite wives in the marriage and gave birth to more children. Finally, the Igbo people of southern Nigeria specifically prohibit both parallel- and cross-cousin marriage, though polygamy is common. Men are forbidden to marry within their own patrilineage or those of their mother or father’s mother and must marry outside their own village. Igbo are almost entirely Christian, having converted heavily under colonialism

In Ethiopia the ruling Christian Amhara people were historically rigidly opposed to cousin marriage, and could consider up to third cousins the equivalent of brother and sister, with marriage at least ostensibly prohibited out to sixth cousins. A man marrying a former wife’s “sister” was seen as incest, and conversely for a woman and her former husband’s “brother.” Though Muslims make up over a third of the Ethiopian population, and Islam has been present in the country since the time of Muhammad, cross-cousin marriage is very rare among most Ethiopian Muslims.

South Asia

Attitudes in India on cousin marriage vary by region and culture. For Muslims it is acceptable and legal to marry a first cousin but for Hindus it may be illegal under the 1955 Hindu Marriage Act, though the specific situation is more complex. The Hindu Marriage Act makes cousin marriage illegal for Hindus with the exception of marriages permitted by regional custom. Cousin marriage is proscribed and seen as incest for Hindus in north India. In fact it may even be unacceptable to marry within one’s village or for two siblings to marry partners from the same village but in south India it is common for Hindu’s to marry cross cousins, with matrilateral cross-cousin (mother’s brother’s daughter) marriages being especially favoured. In Mumbai, studies done in 1956 showed 7.7% of Hindus married to a second cousin or closer in contrast to the northern city of New Delhi where only 0.1% of Hindus were married to a first cousin during the 1980s.

India’s Muslim minority represents about 12% of its population (excluding Jammu and Kashmir) and has an overall rate of cousin marriage of 22% according to a 2000 report. Most Muslim cousin marriages were between first cousins with a rate of 20%.

United Kingdom

There has been a great deal of debate in the past few years in the United Kingdom about whether to discourage cousin marriages through government public relations campaigns or ban them entirely. The debate has been prompted by a Pakistani immigrant population making up 1.5% of the British population, of whom about 55% marry a first cousin. There is evidence that the rate of cousin marriage has increased among British Pakistanis from rates in their parents’ generation. Most British Pakistani marriages are arranged, but these can be of two types: conventionally arranged marriages where the bride and groom have little or no say, and what some British Pakistanis describe as “arranged love marriages” where the bride and groom play an important role.

Other regions

In the East, South Korea is especially restrictive with bans on marriage out to third cousins, with all couples having the same surname and region of origin having been prohibited from marrying until 1997. Taiwan, North Korea, and the Philippines also prohibit first-cousin marriage. It is allowed in Japan, though the incidence has declined in recent years. China has banned it since passing its 1981 Marriage Law, yet there is a conspicuous lack of data on actual cousin marriage rates there.

Recent 2001 data for Brazil indicates a rate of cousin marriage of 1.1%, down from 4.8% in 1957. For example, in São Paulo in the mid-19th century the rate of cousin marriage apparently was 16%, but a century later it was merely 1.9%.

Social aspects of cousin marriages

People may think that cousin marriages are more common among those of low socioeconomic status, among the illiterate and uneducated, and in rural areas due to the dowries and bridewealths that exist, but some societies also report a high prevalence among land-owning families and the ruling elite: here the relevant consideration is thought to be keeping the family estate intact over generations.

In South Asia, rising demands for dowry payments have caused economic hardship and have been linked to “dowry deaths” in a number of North Indian states. The increasing number of cousin marriages in the West may also occur as a result of immigration from Asia and Africa and some observers have concluded that the only new forces that could discourage such unions are government bans like the one China enacted in 1981.

Genetics

In April 2002, the Journal of Genetic Counseling released a report which estimated the average risk of birth defects in a child born of first cousins at 1.7–2.8% over an average base risk for non-cousin couples of 3%, or about the same as that of any woman over age 40. In terms of mortality, a 1994 study found a mean excess pre-reproductive mortality rate of 4.4%, while another study published in 2009 suggests the rate may be closer to 3.5%. Put differently, first-cousin marriage entails a similar increased risk of birth defects and mortality as a woman faces when she gives birth at age 41 rather than at 30. Critics argue that banning first-cousin marriages would make as much sense as trying to ban childbearing by older women.

In Pakistan, where there has been cousin marriage for generations and the current rate may exceed 50%, one study estimated infant mortality at 12.7 % for married double first cousins, 7.9 % for first cousins, 9.2 % for first cousins once removed/double second cousins, 6.9 % for second cousins, and 5.1 percent among nonconsanguineous progeny. Among double first cousin progeny, 41.2 % of prereproductive deaths were associated with the expression of detrimental recessive genes, with equivalent values of 26.0, 14.9, and 8.1 % for first cousins, first cousins once removed/double second cousins, and second cousins respectively.

For example because the entire Amish population is descended from only a few hundred 18th century German-Swiss settlers, the average coefficient of inbreeding between two random Amish is higher than between two non-Amish second cousins. First-cousin marriage is taboo among Amish but they still suffer from several rare genetic disorders. In Ohio’s Geagua County, Amish make up only about 10 % of the population but represent half the special needs cases. Similar disorders have been found in the highly polygamous FLDS, who do allow first-cousin marriage and of whom 75 to 80 % are related to two 1930s founders.

A BBC report reported about Pakistanis in Britain where 55% of whom had married a first cousin and many children come from repeat generations of first-cousin marriages. The report stated that these children were 13 times more likely than the general population to produce children with genetic disorders, and one in ten children of first-cousin marriages in Birmingham either died in infancy or would develop a serious disability. The BBC story contained an interview with Myra Ali, whose parents and grandparents were all first cousins. She has a very rare recessive genetic condition, known as Epidermolysis bullosa which will cause her to lead a life of extreme physical suffering, limited human contact and probably an early death from skin cancer. Knowing that cousin marriages increase the probability of recessive genetic conditions, she is against the practice. Finally, in 2010 the Telegraph reported that cousin marriage among the British Pakistani community resulted in 700 children being born every year with genetic disabilities.

The increased mortality and birth defects observed among British Pakistanis may, however, have another source besides current consanguinity. Genetic effects from cousin marriage in Britain are more obvious than in a developing country like Pakistan because the number of confounding environmental diseases is lower. Increased focus on genetic disease in developing countries may eventually result from progress in eliminating environmental diseases there as well.

Public Health in Norway published in March 2007 a research on intermarriage in Norway. The report identifies both the prevalence of intermarriage and the medical consequences for the children. The analysis was done on the basis of data from the Medical Birth Registry, Statistics Norway, Population Register and the Cause of Death Register of data for all persons born in Norway from 1967 to 2005 because Norway is the only country in the world that keeps the statistic numbers between the parents of all born babies. These were the key findings:

Prevalence of intermarriage:

In Norway, the most widespread intermarriage can be found among people of Pakistani origin. In first-generation immigrants from Pakistan intermarriage is 43.9% of all children born of parents who are cousins, and the total intermarriage ratio is 54.4%.

Among the descendants of first generation immigrants from Pakistan, the proportion of cousin pairs 35.1%, and the total intermarriage ratio 46.5%. Interbreeding units are therefore somewhat lower than in the parental generation.

Intermarriage-shares seem to be heading down in the Norwegian-Pakistani population, both first generation immigrants and descendants.

Intermarriage is relatively common also among people with origins from Turkey, Iraq, Iran, Sri Lanka, Morocco and Somalia.

For people of Norwegian origin, intermarriage is very rare, but it used to be more common a few decades back. This particularly applies to second cousin marriages. In those of Norwegian origin is 0.1% of parental pairs cousins ​​and second cousins ​​0.4% (in the period from 1967 to 2005).

Medical risks of intermarriage Intermarriage leads to increased risk of stillbirth, infant death and congenital malformations. In addition, there is an increased risk of death right up to adulthood among children of intermarried parents.
For children of cousin marriage is the increase of risk in the following order:

Stillbirth: 60%

Deaths during the first year: 150%

Congenital malformations: 100%

Deaths from the age of one year and up to adulthood: 75%

These findings are statistically reliable, and not the result of random variation.

The significance of intermarriage for public health Since intermarriage is rare in the population as a whole, intermarriage does little for public health in Norway, however, it is a major cause of illness and death among children in the country groups where intermarriage is common.
One must always bear in mind that most children of intermarriage, marriage is healthy and completely normal. Illness and death affects only a small minority of them.

Jewish communities affected by Tay-Sachs

Tay–Sachs disease (TSD, also known as GM2 gangliosidosis or Hexosaminidase A deficiency) is an autosomal recessive genetic disorder. In its most common variant, known as infantile Tay–Sachs disease, it causes a relentless deterioration of mental and physical abilities that commences around 6 months of age and usually results in death by the age of 4. Tay-Sachs is caused by a genetic defect in a single gene with one defective copy of that gene inherited from each parent. The disease occurs when harmful quantities of gangliosides accumulate in the nerve cells of the brain, eventually leading to the premature death of those cells. There is currently no cure or treatment but the Tay–Sachs disease is rare.

Tay-Sachs disease was named after British ophthalmologist Warren Tay, who first described the red spot on the retina of the eye in 1881, and the American neurologist Bernard Sachs of Mount Sinai Hospital, New York who described the cellular changes of Tay-Sachs and noted an increased prevalence in the Eastern European Jewish (Ashkenazi) population in 1887. Research in the late 20th century demonstrated that Tay–Sachs disease is caused by a genetic mutation on the HEXA gene on chromosome 15. These mutations reach significant frequencies in several populations. French Canadians of southeastern Quebec have a carrier frequency similar to Ashkenazi Jews, but they carry a different mutation. Many Cajuns of southern Louisiana carry the same mutation that is most common in Ashkenazi Jews. Most HEXA mutations are rare, and do not occur in genetically isolated populations. The disease can potentially occur from the inheritance of two unrelated mutations in the HEXA gene.

Millions of Ashkenazi Jews have been screened as Tay-Sachs carriers since carrier testing began in 1971. Jewish communities, both in and outside of Israel, embraced the cause of genetic screening from the 1970s on and the increasing number of Tay–Sachs disease led Israel to become the first country to offer free genetic screening and counseling for all couples making Israel a leading center for research on genetic disease. Both the Jewish and Arab/Palestinian populations in Israel contain many ethnic and religious minority groups, and Israel’s initial success with Tay–Sachs disease has led to the development of screening programs for other diseases.

Tay-Sachs has sometimes created an impression that Jews are more susceptible to genetic disease than other populations. Sheila Rothman and Sherry Brandt-Rauf, of Columbia University’s Center for the Study of Society and Medicine, have criticized this emphasis on ethnic identity in the study of disease. When several breast cancer mutations were discovered in the 1990s, the TSD model was applied, both consciously and inadvertently. Researchers had initially focused on breast cancer cluster families, not on ethnic groups. But because thousands of stored DNA samples were available from Tay-Sachs screening, researchers were quickly able to estimate the frequency of newly discovered mutations in Ashkenazi Jewish populations.

Inbreeding in the Royal and Nobel families

The family relationships of royalty are usually well known to be highly inbreeded. Royal intermarriage was mostly practised to protect property, wealth, and position.

In ancient Egypt, royal women carried the bloodlines and so it was advantageous for a pharaoh to marry his sister or half-sister. Normally the old ruler’s eldest son and daughter (who could be either siblings or half-siblings) became the new rulers. All rulers of the Ptolemaic dynasty from Ptolemy II were married to their brothers and sisters, to keep the Ptolemaic blood “pure” and to strengthen the line of succession. Cleopatra VII (also called Cleopatra VI) and Ptolemy XIII, who married and became co-rulers of ancient Egypt following their father’s death, are the most widely known example of brother and sister marriage.

The family-tree of Charles II of Spain shows an extraordinary number of uncle-niece and cousin unions of varying degrees that can be seen on the picture.

Click at the picture for a larger image

Among European monarchies Jean V of Armagnac formed a rare brother-sister relationship. Also other royal houses, such as the Wittelsbachs had marriages among aunts, uncles, nieces, and nephews. The British royal family had several marriages as close as the first cousin, but none closer.

The most famous example of a genetic disorder aggravated by royal family intermarriage was the House of Habsburg, which inmarried particularly often. Famous in this case is the Habsburg jaw/Habsburg lip/Austrian lip typical for many Habsburg relatives over a period of 6 centuries. The condition progressed through the generations to the point that the last of the Spanish Habsburgs, Charles II of Spain, could not properly chew his food.

Besides the jaw deformity, Charles II also had a huge number of other genetic physical, intellectual, sexual, and emotional problems. It is speculated that the simultaneous occurrence in Charles II of two different genetic disorders: combined pituitary hormone deficiency and distal renal tubular acidosis could explain most of the complex clinical profile of this king, including his impotence/infertility which in the last instance led to the extinction of the dynasty.

The most famous genetic disease that circulated among European royalty was haemophilia. Because the progenitor, Queen Victoria, was in a first cousin marriage, it is often mistakenly believed that the cause was consanguinity, however, this disease is generally not aggravated by cousin marriages, although rare cases of haemophilia in girls (though not including Victoria) are thought to result from the union of haemophilic men and their cousins.

Intermarriage within European royal families has declined in relation to the past. Inter-nobility marriage was used as a method of forming political alliances among elite power-brokers and these ties were often sealed only upon the birth of progeny within the arranged marriage. Marriage was seen as a union of lines of nobility, not of a contract between individuals as it is seen today.

Some Peruvian Sapa Incas married their sisters. The Inca had an unwritten rule that the new ruler must be a son of the Inca and his wife and sister. He then had to marry his sister (not half-sister), which ultimately led to the catastrophic Huáscar’s reign, culminating in a civil war and then fall of the empire.

Queen Victoria

Royal dyslexia When we look at the Norwegian history, marriage between cousins was rare and attempted to be prohibited in 1687 but the exception was the royals. They married relatives to build alliances, and ensure values ​​and positions. It is not different from the today’s cousin marriages except the only difference was that the royal house had a stronger fundamental superstructure that was at the family’s superiority. Monarchical thinking assumes that your place in society is God-given and that your family is predetermined.

King Olav V and Queen Maud of Norway
To keep the heritage in their own hands, the Spanish Habsburgs started to marry more and more within the family. The result was that the lethal inbreeding within a few generations brought the male succession to destruction with 11 royal marriages in 200 years. 9 of these were intermarriages including two marriages between uncles and nieces and four between cousins. As a consequence of this, the Habsburgs suffered stillbirths and deaths of babies. Between 1527 and 1661 there was born 34 children and of these, 10 died before the age of 1 year. Another 17 died before the age of 10.

The Habsburgs last king, Carlos II, was born in 1661 and the Spaniards called him El hechizado, the enchanted. He had a large head and was relatively weak as a baby. He did not learn to speak before he turned four, and learned to walk when he was eight years old and stayed weak and very thin. His first and second wife claimed he was impotent and he would vomit and suffer from diarrhea. As a 30-year-old, King Carlos looked like he was an old man. He also couldn’t manage to bring an heir so the Halsburg Dynasty died with him in 1700.
Scientists have calculated that 25.4% of his gene variants were inherited in double dose and they believe he was hit by two genetic diseases that today are known as CPHD and distal renal tubular acidos (dRTA).

The Danish royal house was struggling with similar problems. Early in the 1800s did not King. Several diseases spread in the European royal houses of the 1800s and the British Queen Victoria’s descendants were affected by haemophilia resulting in her son Leopold death of the disease as 30-year-old. Her daughters, Princess Beatrice and Princess Alice brought the disease to the European royal houses.

Porphyria is another “royal disease” and the British king George III (1760 to 1820) was known as “Mad George” for his madness. Two professors of molecular genetics, Martin Warren and David Hunt of the University of London, examined in the book Purple Secret (1998) a thesis that George III’s illness was porphyria. They followed “Mad George” s genes down to today’s royals, and estimated that the Queen’s cousin William, who died in 1972, suffered from the disease. Also porphyria was brought further into the European royal families.
Norwegian Princess Astrid has been open to and told how she has experienced it to be dyslexic, like King Olaf was and the Princess’ five children also struggling with this problem.
In contrast, Swedish King Carl Gustaf, the Crown Princess Victoria and her brother Prince Carl Philip has been open with the disorder.

Swedish royal family

Camilla Stoltenberg of Public Health in Norway explains:
“If you inherit the gene from one parent, you may get a slight degree of the condition. Inherit it from both mother and father, the stronger the disposition, and then you can get a more serious disorder.” What then is the relationship between intermarriage and dyslexia?
“The chance that you get two identical copies of a gene is higher. This is also true for genes that predispose to dyslexia. And since dyslexia is probably conditioned by many genes, it is also a greater chance that you may have received two copies of several of the dysleksidisponerende genes,” she says.

Many couples consider children as a very important part of their life and for those who have difficulty conceiving one can be a hard obstacle to tackle. Some couples do whatever they can such as various treatments, acupuncture, medicine treatment and IVF treatments while others feels that the pressure becomes too hard and they separate. Infertility primarily refers to the biological inability of a person to contribute to conception. Infertility may also refer to the state of a woman who is unable to carry a pregnancy to full term. There are many biological causes of infertility, some which may be bypassed with medical intervention.

In vitro fertilization (IVF) is a process by which egg cells are fertilized by sperm outside the body, in vitro. IVF is a major treatment in infertility when other methods of assisted reproductive technology have failed. The process involves hormonally controlling the ovulatory process, removing ova (eggs) from the woman’s ovaries and letting sperm fertilize them in a fluid medium. The fertilized egg (zygote) is then transferred to the patient’s uterus with the intent to establish a successful pregnancy. Robert G. Edwards, the doctor who developed the treatment, was awarded the Nobel Prize in Physiology or Medicine in 2010.

Some people decide to take the step to adopt a child but the negative aspects of this are that most adoptions take very long time. It’s a paradox if we think of the number of orphan children around the world and that those who apply for adoption have to wait for many years in line before they can add a new family member to their household. Therefore lately there is a rising use of surrogate mothers around the world. Surrogacy was first heard mostly in the media where Hollywood actors and actresses used but now, common people tend to use this method.

Surrogacy can be defined as an arrangement where a woman carries and delivers a baby for another person or a couple. This woman may be the genetic mother of this child (traditional surrogacy) or she may carry the pregnancy to deliver after having an embryo which she has no genetic relationship to (gestational surrogacy). If the pregnant woman receives compensation for carrying and delivering the baby besides medical and other expenses, it is called commercial surrogacy; otherwise the arrangement is called altruistic surrogacy.

The social parents, those that intend to raise the child arrange a surrogate pregnancy because of female infertility, or other medical issues which may make the pregnancy or delivery impossible, risky or otherwise undesirable. The social mother could also be fertile and healthy, and prefer the convenience of someone else undergoing pregnancy, labor, and delivery for her. The intended parent could also be a single man or woman wishing to have his/her own biological child and the legality of surrogacy arrangements vary widely between jurisdictions.

Usually, though, the etiquette is that the biological parents will provide the surrogate mother with any necessities the surrogate needs in the pregnancy such as providing transportation to and from doctor’s appointments; covering the costs of doctor visits, medications, procedures, hospital stay, and delivery fees (emergency and nonemergency) if medical insurance is not available by the surrogate; providing maternal clothing for the surrogate; if the surrogate was working before but quit to do the surrogacy, the biological parents will cover life necessities such as food, bills and etc.

INDIA: New regulation for India’s booming surrogate mother industry

Until recently, the 350 clinics offering surrogate mother services to the hundreds of medical tourists coming to India every week have been unregulated. But legal cases in India and other countries mean that this profitable free-for-all will be replaced by regulated agencies being forced to comply with national and international law. That may soon change. A draft bill to direct assisted reproductive technology (ART) is likely to be introduced this year in Parliament. India’s Supreme Court has demanded urgent new legislation to regulate one of India’s fastest-growing industries as they have become the world capital of outsourced pregnancies, where surrogates are implanted with foreign embryos and paid to carry the resultant babies to term. In 2002, the country legalized commercial surrogacy in an effort to promote medical tourism and Indian surrogate mothers are considered as available and cheap. In 2002 the country legalized commercial surrogacy in an effort to promote medical tourism; a sector the Confederation of Indian Industry predicts will generate $2.3 billion annually by 2012.

Many of the couples using India are from countries where surrogacy is either illegal or unaffordable. Surrogacy costs $12,000 to $20,000 per birth in India, compared to $70,000 to $100,000 in the USA. Indian surrogates are usually paid between 5,000 to $ 7,000 for their services, which is more than many of them would be able to earn after years of work. In some Indian clinics surrogates are recruited from rural villages, with most recruits being poor and illiterate. Surrogacy recruits are also brought to the clinics where they are required to stay in the clinic’s living quarters in a guarded dormitory-like setting for the entire pregnancy where they are being taking care of in case of complications.

There have been several cases in which babies born from Indian surrogacy arrangements were stateless, in which neither India nor the parents’ home countries recognized the babies’ citizenship. “We can only wish them good luck,” India’s Supreme Court told local media. Japan considers the woman who gives birth to a baby, the surrogate, to be the baby’s mother just like Norway does. Until recently, two-year-old twin toddlers were stateless and stranded in India. Their parents are German nationals, but the woman to whom the babies were born is an Indian surrogate. The boys were refused German passports because the country does not recognize surrogacy as a legitimate means of parenthood. And India does not confer citizenship on surrogate-born children conceived by foreigners. Only after a long legal battle did Germany allow the boys German passports.

The new proposed government bill bans in-vitro fertilization (IVF) clinics from brokering surrogacy transactions. It also calls for the establishment of an ART bank that will be responsible for locating surrogate mothers, as well as reproductive donors and fertility clinics will only come into contact with surrogates on the operating table but clinics see this as unworkable as they want to perform medical and background checks. But the new rules seek to protect surrogate mothers with freedom in negotiating their fee and mandatory health insurance from the couple or single employing them. The legislation will only allow a woman to act as a surrogate up to five times, less if she has her own children, and will impose a 35-year age limit. At the same time, the new legislation will also require and make sure that the international couple’s home country guarantees the unborn infant citizenship before a surrogacy can begin. If this stipulation becomes law it could kill the industry as few countries will or legally could guarantee citizenship before birth. Countries accepting surrogate-born children typically rely on DNA tests done post-delivery to determine the parentage of the baby.

How will the legislation affect Indian clinics?

Dr. Patel chooses among the women who appear at the clinic, at least three a day, hoping to hire out their wombs and she pairs the surrogates with infertile couples, catering to an increasingly international clientele from 13 foreign couples in 2006 to 85 in 2009. The entire process costs customers around $23,000 less than 1/5 of the going rate in the U.S. of which the surrogate mother usually receives about $7,500 in installments. Dr. Patel implants the women with embryos, using specimens from sperm or egg donors if necessary. Once pregnant, the surrogates are housed onsite, in a dormitory that was once a local tax office, so that they can be supervised until delivery. But under the new legislation, Patel will be permitted to supervise nothing but surgery.

Surrogate mothers waiting for check up

The proposed bill bans in vitro fertilization (IVF) clinics from brokering surrogacy transactions. It also emphasizes for the establishment of an “ART bank” that will be responsible for locating surrogate mothers as well as reproductive donors. Fertility clinics will only come into contact with surrogates on the operating table and the reason for this is to create a safe distance between the clinic and the surrogate to avoid unethical practices according to Dr. R.S. Sharma, deputy director general of the ICMR and member-secretary of the bill’s drafting committee. “IVF clinics should only be concerning themselves with science.”

Dr Patel does not agree with the legislation maintains that ART banks will not have enough experience to determine whether a woman is fit for surrogacy. “The trust the clients and surrogate mothers have with me is what makes the whole thing secure and safe. And at the end, when they want to buy a house or a piece of land for farming, we get them the best deal. With this bill, we will not know what they are going to do with such a big amount of money,” she says.

Stateless children

During nine months, Kari Ann Volden, a Norwegian woman have been battling against the Norwegian government to adopt the twins Adrian and Michael, who was born from a surrogate mother in India January 24, 2010. According to Norwegian rule, the woman who gives birth to the child is the legal mother.

Family Minister Audun Lysbakken promised in May 2010 that the Ministry should take into account the children and make a moral exception in the case even if Kari Ann Volden was not considered to be the mother of the children but when it emerged that she had lied about the eggs being hers the application then was rejected. Therefore she is now caught in India with the two young boys hoping that her adoption application still will be granted.

According to the Norwegian authorities, the children are Indian government’s responsibility. But Indian authorities claim that the children are Norwegian and the twins are therefore now stateless. Norwegian government justifies the refusal on the basis of international conventions and Norwegian law to prevent the purchase and sale of children. This is the first time that such a case is dealt with in Norway. Norway has ratified the Convention on Human Rights, which states that children’s best interests will be emphasized, even when it comes to adoption across national borders. And that’s what this case is all about children’s best interests, not their biological connection.

After the birth of the two boys, the authorities demanded a DNA test to finish up the adoption process, and Volden admitted then that both eggs and sperm was donated and the Norwegian adoption authorities put their foot down for the adoption of the two twins. Volden is sorry that she had told the adoption authorities that the eggs were hers but says she said it to protect the boys and herself. “I did not think that the case would receive such attention. I thought we would be in India for seven weeks, but now we have been here for seven months,” she said.

Labor Party politician has followed the case with great interest for a long period. The case created great interest among the people, expressed both through the Facebook support group and fundraising since Volden is suffering economically. Much indicated that the case was about to resolve it when the family minister Audun Lysbakken opened to domestic adoption, but it was paradoxically this opportunity that led to incorrect information was revealed.

Indian surrogate mother: “We do it for money”

Regina A. Singh has never met the Norwegian father who applied for surrogacy alone and she thinks it’s strange to carry out a child who should not have a mother. “It would never have happened in India. But I do not think about it. This is not my baby,” Regina says. She is 23 years old and has two children from before herself. This is her first time as a surrogate mother. “We needed the money. First, my husband refused, but I managed to persuade him,” she said. For the job, she gets 350,000 rupees, around $7,740 and that is a fortune for the family of four, which until now have lived by the husband’s income of about $ 900 a month. But Regina has chosen to keep the matter secret from the in-laws as they would never understand. In the tradition-bound India, it is often associated with shame to rent out her womb for others especially in rural areas; surrogacy is combined with social stigma, and is seen as dirty and immoral.

Udmala Mansoya (30) and Hema Rawal (34) admittes its hard work but they do it for the money. Both have undergone multiple pregnancies earlier but this is completely different. Both agree that once is enough for them as a surrogate mother. Udmala will use the money to buy a house, while Hema will ensure that her own three children receive education, but none of them get the money in hand, they are managed for them by Akanksha Clinic. “Many of the women can not read or write, so we think it is best that we look after their money for them,” says clinic administrator Himesh Patel who helps the women with house and land purchase. If something were to happen during pregnancy or birth the women have little protection as Indian insurance companies refuse to insure pregnant women, and women are therefore at the mercy of their employers.”We did not know this. But we hope it goes well,” says Hema and Udmala.

Good health is the key for a long and happy life, but how often do we go to the doctor and check our body from top to toe? Luckily for us, there are a few steps we can do ourselves at home.

1. Check your resting heart rate.

Resting heart rate indicates how effectively your heart is. When you exercise and get in better physical shape, your heart will be ever more efficient, pumping more blood around the body with each heartbeat. What you coach at the endurance exercise, oxygen uptake, endurance, and it is primarily the heart’s stroke volume – how much blood the heart pumps out per stroke – that increases and improves maximal oxygen uptake or improved condition. Resting heart rate is reduced when stroke volume increases; therefore, resting heart rate is an indication of fitness. An average heart beats about 60-80 beats each minute when the body is at rest.

How to test:
When you wake up in the morning before you stand up from bed, check your resting heart rate by placing the forefinger and middle finger lightly over the main arteries of the wrist or neck artery, which is about 2.5 cm from the trachea, on each side of the neck. Count your strokes in 15 seconds and multiply the number by four to get the number of beats per minute.
You can also test by using a heart rate monitor.

30-40 beats per minute: Very well trained, at the elite level athlete.

40-50 beats per minute: You are very healthy and well trained.

50-60 beats per minute: Wanted: people usually have a resting pulse below 60, then you’re doing well.

65 + beats per minute: 60-70 beats per minute is considered normal. Is resting heart rate 75 or higher, then that is a sign of increased risk of heart attack, according to a Norwegian study. In other words, there is good reason to aim to reduce the resting heart rate with exercise. Be aware that some medications / drugs will affect heart rate. Some are born with naturally high resting heart rate even if the shape is good.

2. Check your eyes

The eyes can give you an indication of your cholesterol level. White matting around the edge of the iris of the eye could be a sign that the cholesterol is too high. High levels of cholesterol in the blood increases the risk of cardiovascular disease, like heart attacks

How to check your eyes:

Look at the iris of your eyes in a mirror. Is there white matting around the edge of the iris of the eye or a little inside? If so, this may be a sign of high cholesterol. Go to the doctor and take a blood test, and make sure your diet includes plenty of fruits, vegetables and oats, which lower the cholesterol.

3. The secret is in the waist measurement, the bigger the waist, the higher the risk for heart diseases.

Measurement of the waist:

Measure around your stomach between the lower rib and iliac crest while standing without any clothes on. It is important that you relax, do not hold your breath and breathing in the abdomen or exhale and balusters on the stomach.

* Women should be aware if the waistline is about 80 cm, and should take some measures if the waistline is about 88 cm or more.
* Men should be aware if the waistline is about 94 cm, and should do something if the waistline is about 102 cm or more.

A European study found that the risk of premature death is about twice as large for people with a lot of fat around the waist (more than 120 cm for men and more than 100 cm for women), compared with those with a narrow waist (smaller than 80 cm for men and less than 65 cm for women). The researchers behind the study believe the increased risk of premature death due to abdominal fat secretes substances and hormones that can help you develop chronic diseases, especially heart disease and cancer.

4. Check your responsiveness
How fast do you manage to grab something that is falling?

How to test?

Get somebody to hold a 30 cm long stick in front of you. The person shall keep the stick at the end where it says 30 cm, and the stick should be facing down. Place your hand on a level with 0-marked, with the thumb and index finger ready to intervene. Without warning, your friend will drop the ruler. You should grab it as quickly as you can, before it goes to the floor. Then, note the length of your finger where you grabbed the ruler.
Under 5 cm: Great
Under 10 cm: Average
Between 10 0g 29 cm: Are you sure that you get enough exercise and rest?
Boom: You can have low levels of potassium and need to exercise more.

5. Check your flexibility. One side of the body may be softer than the other.

To test your flexibility:
Stand with your right arm straight up in the air, bend your elbow so your hand hangs behind you. Raise your left arm up behind his back, as if to scratch between the shoulder blades, and try to obtain the other hand, as if you shake hands on yourself behind your back. Repeat on other side. Can you grasp your hands, you are very smooth. To touch the fingertips is the next best. By practicing this, you can improve your flexibility. It is normal to be softer on one side.

6. Check your brain

Your brain needs exercise just as much as the body to work and to strengthen your memory.

To test the brain:
Count backward from 100 for seven figures at a time (100 – 93 – 86 and so on) and try to get as low as you can without stopping. If you come down to 65 is considered a good result. To keep your mind focused, try to solve crosswords daily or read books as often as you can.

Note: These advices are just indicators and may not tell you how your health is 100%, though the best thing is to seek a professional doctor.